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Published in:

01-09-2014

Perioperative Care with Fast-Track Management in Patients Undergoing Pancreaticoduodenectomy

Authors: Shinjiro Kobayashi, Ryuiti Ooshima, Satoshi Koizumi, Masafumi Katayama, Joe Sakurai, Taiji Watanabe, Hiroshi Nakano, Toshihide Imaizumi, Takehito Otsubo

Published in: World Journal of Surgery | Issue 9/2014

Abstract

Background

It has been considered that allowing patients to return to daily life earlier after surgery helps recovery of physiological function and reduces postoperative complications and hospital stay. We investigated the usefulness of fast-track management in perioperative care of patients undergoing pancreaticoduodenectomy (PD).

Methods

Patients (n = 90) who received conventional perioperative management from 2005 to 2009 were included as the ‘conventional group’ (historical control group), and patients who received perioperative care with fast-track management (n = 100) from 2010 to March 2013 were included as the ‘fast-track group’. To evaluate the efficacy of perioperative care with fast-track management, the incidence of postoperative complications and the length of hospital stay were compared between the two groups (comparative study). For statistical analysis, univariate analysis was performed using the χ ² test or Fisher’s exact test.

Results

There was no significant difference between the two groups in sex, mean age, presence/absence of diabetes mellitus, preoperative drainage for jaundice, previous disease, operative procedure, mean duration of operation, or blood loss (p < 0.01). The incidence of surgical site infection in the conventional group and fast-track group was 28.9 and 14.0 %, respectively, with a significant difference between the two groups (p = 0.019). In addition, the incidence of pancreatic fistula (grade B, C) significantly differed between the two groups (27.8 % in the conventional group, 9.0 % in the fast-track group; p = 0.001). The mean postoperative hospital stay was 36.3 days in the conventional group and 21.9 days in the fast-track group (p < 0.001).

Conclusions

Perioperative care with fast-track management may reduce postoperative complications and decrease the length of hospital stay in patients undergoing PD.

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Title: Perioperative Care with Fast-Track Management in Patients Undergoing Pancreaticoduodenectomy
Authors: Shinjiro Kobayashi
Ryuiti Ooshima
Satoshi Koizumi
Masafumi Katayama
Joe Sakurai
Taiji Watanabe
Hiroshi Nakano
Toshihide Imaizumi
Takehito Otsubo
Publication date: 01-09-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 9/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-014-2548-5

At a glance: The STEP trials

Springer Medicine

Perioperative Care with Fast-Track Management in Patients Undergoing Pancreaticoduodenectomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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